冠心病患者血浆hs-CRP、IL-6和可溶性IL-6受体水平的变化及意义
The variation and significance of plasma hs-CRP, IL-6 and sIL-6R levels in coronary heart disease patients

摘要：目的 探讨高敏C反应蛋白(high sensitivity C reactive protein, hs-CRP)、白细胞介素-6(interleukin-6, IL-6)及可溶性IL-6受体(soluble IL-6 receptor, sIL-6R)与冠心病(coronary heart disease, CHD)患者临床症状及冠状动脉病变严重程度之间的关系。 方法 收集CHD患者522例，分为稳定性心绞痛(SAP)、不稳定性心绞痛(UAP)及急性心肌梗死(AMI)组，并设正常对照(NC)组102例。收集其临床资料并根据冠脉造影结果计算Gensini积分，比较不同组间hs-CRP、IL-6及sIL-6R水平之间的差异，并与Gensini积分进行相关性分析。结果 与NC组相比，SAP、UAP及AMI组的hs-CRP、IL-6水平明显增高而sIL-6R水平明显降低，差异有统计学意义(P<0.05)。多元线性回归结果显示IL-6水平与Gensini评分呈正相关，而sIL-6R水平与Gensini评分呈负相关(P<0.05)。结论 CHD患者血浆hs-CRP、IL-6及sIL-6R水平与CHD临床症状及冠状动脉病变程度相关，对CHD的发展及预后有一定的预测价值。
ABSTRACT: Objective To investigate the relationship of high sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) with the severity of clinical symptoms and coronary artery lesions in coronary heart disease (CHD) patients. Methods A total of 522 CHD patients were recruited and divided into three groups: stable angina pectoris (SAP), unstable angina pectoris (UAP) and acute myocardial infarction (AMI) groups. Another 102 healthy individuals served as normal controls (NCs). We calculated Gensini score according to the result of coronary angiography (CAG), collected clinical data and compared the groups. Multiple linear regression analysis was used to investigate the relationship of hs-CRP, IL-6 and sIL-6R with Gensini score. Results The plasma hs-CRP, IL-6 levels were significantly higher and sIL-6R level was signficantly lower in SAP, UAP and AMI groups than in NC group (P<0.05). There was a positive correlation between IL-6 level and Gensini score but a negative correlation between sIL-6R and Gensini score presented by multiple linear regression analysis (P<0.05). Conclusion In CHD patients, plasma hs-CRP, IL-6 and sIL-6R levels are significantly related to the severity of clinical manifestations and coronary artery stenosis. These indicators may help predict the severity of CHD